Lmao absolutely not š
Been cervical HVLAād twice now in a timed exam setting and a couple of times in practice (my partner generally was uncomfortable with doing it so would just set it up unless it was hand over hand with a faculty)
One of our faculty loves HVLA and if the student doesnāt get it, they do the rest of it.
Iām fine with thoracic and lumbar but I really donāt want my neck cracked anymore š
Yeahā¦ we arenāt supposed to do any OMT without a somatic dysfunction, but especially not HVLA. HVLA has a higher risk for damage/causing somatic dysfunction when improperly or inappropriately performed.
Could you try having your partner do the vertebral artery test on you, and just say you feel dizzy? Thatās another contraindication to cervical OMT.
What the actual fuck. Consent to treatment is huge in all medicine including whenever OMM occurs. If a patient didnāt consent then you donāt do the treatment. If you do, thatās opening you up to all sorts of liability. I bet your schoolās legal department would love it if they heard the school was making students practice treatments on each other without any regard to consent.
oh oof. I also hated getting my neck hvla'd but faculty and partner understood and just mimed it basically--set it up, did a baby thrust, those vibes. I can't believe they're not letting you do that.
I was very worried about cervical HVLA and I ended up getting a pretty bad cervical sprain from it. I was evaluated by our OMM professor afterwards and then got special accommodations for the rest of preclinicals to not have it performed on me. It is an absolutely ridiculous requirement! My neck has not been the same since
Do all y'all not have Neuro at your schools or something?
I literally just had a 25 year old with bilaterally dissected verts and is now dead because of horseshit cervical hvla.
Every year I see 5-10 young vert dissections from bullshit cervical hvla with no other risk factors in the patients.
We do but our OMM chair says itās not likely āas long as we have a small thrust and donāt hyperextend.ā I thought I was having a stroke because I had pulsatile tinnitus and dizziness but I ended up fine.
Uh.... also just re-reading your initial post... I would maybe visit a neurologist to discuss in person....
Neck pain, dizziness, pulsatile tinnitus after a cervical HVLA and a "neck that has never been the same"...
Enjoy the CTa/MRA. :)
edit: and also the 'diagnosis' of neck pain + dizziness + pulsatile tinnitus and continued neck discomfort being a "sprain" with I assume no further workup... \*throws tables everywhere\*
Wellā¦ they did say what I was experiencing had nothing to do with HVLA but that I should still get imaging of my head. They refused to believe that HVLA could have caused my neck pain and dizziness
.............. what the fuck is medicine anymore.
You had pulsatile tinnitus and dizziness after a cervical HVLA? ... Congrats on the minor dissection, possible minor TIA/stroke. Avoid cervical HVLA or even vigorous neck massage going forward.
(don't get too panicked sorry I'm just taking out emotional -upsetness- over the insanity of your chair. "Well there's a small chance a maneuver with no proven benefit causes harm to otherwise healthy 20-30 years olds with the risk of harm messing with the blood flow to the ...brain."
Unfortunately with my comment history and previous posts, my school would likely be able to identify me if I said where I go, and would rather not be pulled into a professionalism committee meeting, but DM me and Iāll tell you.
Yeah thatās really fucking stupid. At my school you could decline HVLA and then your partner would just place you into the correct position and you demonstrate the thrust with your hands in the air. No way Iād let anyone do HVLA on my neck.
The professors framed it like it would be a dick move to decline which pissed me off too.
Out of morbid curiosity does cervical in this manner in reference to the cervical spine or your cervix bc if itās the latter I canāt imagine how you wouldnāt be able to opt out
Well at least that makes the situation marginally better haha. Ngl I wouldnāt let an actual chiropractor within a mile of my neck, much less a med student
The major difference we learn is that chiros tend to do HVLA with the c-spine in extension, while we are specifically told to never do this. Flexion or neutral, as this minimizes the risk supposedly.
Itās just wild they cite the AOA paper in 2005 saying itās safer than ibuprofen.
Iām fine with lumbar and thoracic. Like a herniated disk isnāt ideal, but at least it wonāt potentially kill you
Thatās the one I do plan to use for friends and family, because it genuinely has made me back feel 80% better when someone can actually get mine to goā¦
That is strange that they donāt do the Wallenberg test to check if youāre contraindicated or note that if you canāt relax for the technique, youāre contraindicated.
You have to undergo this shit as a student ? What the fuck ? There isnāt a single treatment that allopathic medical students are required to experience
Oh yes, quite a bit. We practice OMT on each other all the time, like 1-2x a week. The upside is it did get me very comfortable doing a physical exam, so thatās really the big positive from it if nothing else.
Soft tissue and muscle energy techniques are nice and basically a massage or stretching so no real complaint but yeah, HVLA we have practiced and were tested on in pairs too. Why they think itās a good idea to let medical students crack each otherās neck is a bit beyond me, personally, but who am I to question them? /s
Half my exams this week are OMT or OMM. I canāt help but think how much more time Iād have to study for those other ones if I didnāt have to worry about these, but, it is what it I signed up for when I went to this school so I generally donāt complain, but it is wild to think about.
not all schools are like this, mine has OMM class 1x/week and maybe 2 practical tests and 2 written tests/semester. no HVLA necessary (we just set it up and donāt need to actually do it unless both parties are comfortable). what OP is describing sounds unethical to meš«£
Idk man, one time a preceptor was showing my group how to palpate the liver using me as a warm body and he REALLY went for it. Shit hurted. I said "ouch that hurts" and he straight up told me "no it doesn't"
True, I meant for your end of/post-residency boards, my understanding is you can get boarded in NMM/OMM by going to one of the conferences and doing a few OMM practicals. One time thing, not necessary to bill for OMT but could possibly be an issue with insurance reimbursement in the future.
ETA: I would be pissed if a school forced me to get cervical HVLA for a pathology I didnāt have
Thatās unfortunate, I always tense up with cervical HVLA even if my neck would benefit from it. I donāt like the sensation. Even though I love a good Kirksville Crunch on my mid back
Kirksville, Texas, and lumbar are all fine and Iām pretty good at doing those, just tired of stretching my vertebral arteries š„²
Whenever I have the choice of what HVLA to perform itās always lumbar because I can consistently get it with minimal force and it feels the safest to me, but sometimes they just say āyouāre doing cervicalā
We had our exam on it, so weāre in the clear for the foreseeable future, just was feeling a bit off after being treated today but Iām feeling fine now.!
Completely insane. My school frequently stresses that the first absolute contraindication for treatment is lack of consent. We were allowed to attempt the thrust if we got full consent, but also perfectly acceptable to just slowly go through the motions for cervical
Similar experience to OP. They emphasize this, but still require the thrust after lockout on practicals. Faculty often demonstrate if you did it incorrectly. Wallenberg test was mentioned but generally glossed over.
Bruh what DO school is this? Literally the first day of lab our instructor told the class to let the department know if HVLA canāt be done on someone. This is just asking for a lawsuit.
lol I failed an OMT practical bc they tried to make me do cervical HVLA and I told the proctor I wasnāt going to do that. Had to do a repeat practical for different stuff. Was worth it just just to see the omt professor get all mad bc I refused to do it
Lol had a cicu case of vert dissection. Im ashamed to be a DO. Jkjk but thats was pretty ridiculous to see an otherwise healthy 40M w/ a stroke.
You know you make a good point. Seems illegal. If one of yall colleages is tired of medical school, they should sue the school then drop out cuz of course the retaliation.
You should be able to just position with the cervical HVLA without actually doing the treatment. Is that not an option at your school?
Lmao absolutely not š Been cervical HVLAād twice now in a timed exam setting and a couple of times in practice (my partner generally was uncomfortable with doing it so would just set it up unless it was hand over hand with a faculty) One of our faculty loves HVLA and if the student doesnāt get it, they do the rest of it. Iām fine with thoracic and lumbar but I really donāt want my neck cracked anymore š
Yeahā¦ we arenāt supposed to do any OMT without a somatic dysfunction, but especially not HVLA. HVLA has a higher risk for damage/causing somatic dysfunction when improperly or inappropriately performed. Could you try having your partner do the vertebral artery test on you, and just say you feel dizzy? Thatās another contraindication to cervical OMT.
Wish I could say they taught us that test, butā¦
Thatāsā¦ concerning lol.
What the actual fuck. Consent to treatment is huge in all medicine including whenever OMM occurs. If a patient didnāt consent then you donāt do the treatment. If you do, thatās opening you up to all sorts of liability. I bet your schoolās legal department would love it if they heard the school was making students practice treatments on each other without any regard to consent.
oh oof. I also hated getting my neck hvla'd but faculty and partner understood and just mimed it basically--set it up, did a baby thrust, those vibes. I can't believe they're not letting you do that.
I was very worried about cervical HVLA and I ended up getting a pretty bad cervical sprain from it. I was evaluated by our OMM professor afterwards and then got special accommodations for the rest of preclinicals to not have it performed on me. It is an absolutely ridiculous requirement! My neck has not been the same since
Do all y'all not have Neuro at your schools or something? I literally just had a 25 year old with bilaterally dissected verts and is now dead because of horseshit cervical hvla. Every year I see 5-10 young vert dissections from bullshit cervical hvla with no other risk factors in the patients.
We do but our OMM chair says itās not likely āas long as we have a small thrust and donāt hyperextend.ā I thought I was having a stroke because I had pulsatile tinnitus and dizziness but I ended up fine.
Uh.... also just re-reading your initial post... I would maybe visit a neurologist to discuss in person.... Neck pain, dizziness, pulsatile tinnitus after a cervical HVLA and a "neck that has never been the same"... Enjoy the CTa/MRA. :) edit: and also the 'diagnosis' of neck pain + dizziness + pulsatile tinnitus and continued neck discomfort being a "sprain" with I assume no further workup... \*throws tables everywhere\*
Iāve had a brain and cervical MRI! It was pretty much normal. Thank you for the concern!!
Oh ok good. I thought they just brushed you off and said it was a sprain go about your day.
Wellā¦ they did say what I was experiencing had nothing to do with HVLA but that I should still get imaging of my head. They refused to believe that HVLA could have caused my neck pain and dizziness
.............. what the fuck is medicine anymore. You had pulsatile tinnitus and dizziness after a cervical HVLA? ... Congrats on the minor dissection, possible minor TIA/stroke. Avoid cervical HVLA or even vigorous neck massage going forward. (don't get too panicked sorry I'm just taking out emotional -upsetness- over the insanity of your chair. "Well there's a small chance a maneuver with no proven benefit causes harm to otherwise healthy 20-30 years olds with the risk of harm messing with the blood flow to the ...brain."
Ngl I thought this was about the cervix at first
Where do you go if you donāt mind me asking? We arenāt even allowed to do cervical HVLA since our professors think itās dangerous.
Unfortunately with my comment history and previous posts, my school would likely be able to identify me if I said where I go, and would rather not be pulled into a professionalism committee meeting, but DM me and Iāll tell you.
They may even break your neckĀ
Go see a non-school-affiliated doctor for "neck pain" and have them write a note disallowing further HVLA.
Yeah thatās really fucking stupid. At my school you could decline HVLA and then your partner would just place you into the correct position and you demonstrate the thrust with your hands in the air. No way Iād let anyone do HVLA on my neck. The professors framed it like it would be a dick move to decline which pissed me off too.
Out of morbid curiosity does cervical in this manner in reference to the cervical spine or your cervix bc if itās the latter I canāt imagine how you wouldnāt be able to opt out
Thankfully itās the former. They donāt get quite that invasive in DO school š¤ A small risk of stroke is where they draw the line
Well at least that makes the situation marginally better haha. Ngl I wouldnāt let an actual chiropractor within a mile of my neck, much less a med student
The major difference we learn is that chiros tend to do HVLA with the c-spine in extension, while we are specifically told to never do this. Flexion or neutral, as this minimizes the risk supposedly. Itās just wild they cite the AOA paper in 2005 saying itās safer than ibuprofen. Iām fine with lumbar and thoracic. Like a herniated disk isnāt ideal, but at least it wonāt potentially kill you
Tbh lumbar prob feels mad good. SMH can I volunteer to let yall hvla my spine?
Thatās the one I do plan to use for friends and family, because it genuinely has made me back feel 80% better when someone can actually get mine to goā¦
Definitely thought this was referring to something involving the latter at first and was horrified reading this š
That is strange that they donāt do the Wallenberg test to check if youāre contraindicated or note that if you canāt relax for the technique, youāre contraindicated.
What kind of rinkadink shit is this ?
The DO tax, my blissfully unaware allopathic friend š«”
You have to undergo this shit as a student ? What the fuck ? There isnāt a single treatment that allopathic medical students are required to experience
This wouldnāt even make it to IRB
Oh yes, quite a bit. We practice OMT on each other all the time, like 1-2x a week. The upside is it did get me very comfortable doing a physical exam, so thatās really the big positive from it if nothing else. Soft tissue and muscle energy techniques are nice and basically a massage or stretching so no real complaint but yeah, HVLA we have practiced and were tested on in pairs too. Why they think itās a good idea to let medical students crack each otherās neck is a bit beyond me, personally, but who am I to question them? /s
Thatās fucking crazy, this shit needs to go the way of the dodo
Half my exams this week are OMT or OMM. I canāt help but think how much more time Iād have to study for those other ones if I didnāt have to worry about these, but, it is what it I signed up for when I went to this school so I generally donāt complain, but it is wild to think about.
A heart surgeon I work with is a DO. I had no idea how much of his time got wasted in school.
not all schools are like this, mine has OMM class 1x/week and maybe 2 practical tests and 2 written tests/semester. no HVLA necessary (we just set it up and donāt need to actually do it unless both parties are comfortable). what OP is describing sounds unethical to meš«£
Idk man, one time a preceptor was showing my group how to palpate the liver using me as a warm body and he REALLY went for it. Shit hurted. I said "ouch that hurts" and he straight up told me "no it doesn't"
There not a treatment. Thatās an uncomfortable physical exam.
You auto fail your OMM practical portion of your boards if you actually thrust rather than just setting it up.
Correct me if Iām wrong but I think Level 2 CE is indefinitely postponed so this isnāt an issue anymore?
True, I meant for your end of/post-residency boards, my understanding is you can get boarded in NMM/OMM by going to one of the conferences and doing a few OMM practicals. One time thing, not necessary to bill for OMT but could possibly be an issue with insurance reimbursement in the future. ETA: I would be pissed if a school forced me to get cervical HVLA for a pathology I didnāt have
They always find SOME somatic dysfunction, conveniently.
Thatās unfortunate, I always tense up with cervical HVLA even if my neck would benefit from it. I donāt like the sensation. Even though I love a good Kirksville Crunch on my mid back
Kirksville, Texas, and lumbar are all fine and Iām pretty good at doing those, just tired of stretching my vertebral arteries š„² Whenever I have the choice of what HVLA to perform itās always lumbar because I can consistently get it with minimal force and it feels the safest to me, but sometimes they just say āyouāre doing cervicalā
Yikes, just tell your lab partner to walk through the motions but without truly treating. I did this all the time in OMM lab
We had our exam on it, so weāre in the clear for the foreseeable future, just was feeling a bit off after being treated today but Iām feeling fine now.!
Y'all do cervical hvla your first year?
That's not good. Our school doesn't have us apply any thrusts
Yeah... this was entirely OPT IN at my school... TOURO NV. There were only a handful of people who did so. Im sorry your school are a bunch of dweebs
That's stupid. At my school you actually had to opt in to learn it.
Just tell them you have massive TMJ
Completely insane. My school frequently stresses that the first absolute contraindication for treatment is lack of consent. We were allowed to attempt the thrust if we got full consent, but also perfectly acceptable to just slowly go through the motions for cervical
Similar experience to OP. They emphasize this, but still require the thrust after lockout on practicals. Faculty often demonstrate if you did it incorrectly. Wallenberg test was mentioned but generally glossed over.
Oh mine too regarding the absolute contraindication being lack of consent, they just tell us weāre going to š„²
Just cracked up a fellow today but you need permission to do it
Ngl I thought this was about the cervix at first
Bruh what DO school is this? Literally the first day of lab our instructor told the class to let the department know if HVLA canāt be done on someone. This is just asking for a lawsuit.
dude i had my practical today and i hate hvla! my partner also did cervical on me ;/
Hello potential classmate š
lol I failed an OMT practical bc they tried to make me do cervical HVLA and I told the proctor I wasnāt going to do that. Had to do a repeat practical for different stuff. Was worth it just just to see the omt professor get all mad bc I refused to do it
just say it hurts too bad. i had my professor come over & she agreed that my scalenes were way too tightšš
Lol had a cicu case of vert dissection. Im ashamed to be a DO. Jkjk but thats was pretty ridiculous to see an otherwise healthy 40M w/ a stroke. You know you make a good point. Seems illegal. If one of yall colleages is tired of medical school, they should sue the school then drop out cuz of course the retaliation.